Causes of Eczema

Eczema (atopic dermatitis) is a long-term skin condition. It is not contagious and it is not caused by dirt, poor hygiene or something the person did wrong. It comes from a mix of a weak skin barrier, an overactive immune response, and triggers in the environment.

What is going on in the skin

• A leaky barrier. The outer layer of skin holds in water and keeps out irritants. In eczema it is thinner and leaks moisture, so skin dries, cracks and itches. Many people carry a change in a gene called filaggrin that affects this barrier.
• Immune overactivity. The immune system reacts to substances that do not bother most people, which causes redness, itching and swelling.
• The itch-scratch cycle. Scratching damages the barrier further, which lets in more irritants and germs and makes the itch worse.

Common triggers

• Harsh soaps, detergents and bubble baths.
• Wool and rough fabrics, and sweat.
• Hot baths and showers, and dry or very cold air.
• Dust mites, pet hair, pollen and moulds.
• Stress and poor sleep.
• Skin infections.
• Certain foods in some children, but only when an allergy has been confirmed.

Who is more likely to get it

People with a family history of eczema, asthma or hay fever (the "atopic" family). It often starts in infancy, and many children grow out of the worst of it, while some continue into adulthood.

A classical note. Ayurveda places eczema-like conditions such as vicharchika among the kushtha group of skin diseases, and relates them to dosha imbalance and food and lifestyle factors. This is an interpretive framework for understanding the condition, not a replacement for skin care.

Knowing your own triggers is the first step to fewer flare-ups.